A Clinical Predictive Model of Progesterone Elevation on the Day of HCG Administration Was Establish Based on the Basal P, BMI and Ovarian Induction Regimen

Abstract

Background The progesterone elevation (PE) on the day of human chorionic gonadotrophin (hCG) is associated with a significant decrease in the probability of clinical pregnancy after fresh embryo transfer. The goal of this study was to develop a nomogram to explore the baseline indexes to predict the occurrence of PE (0.9ng/ml) on the day of HCG administration before IVF/ICSI treatment.Methods The patients who were performed a GnRH agonist or antagonist pituitary suppression protocol during controlled ovulation stimulation(COS) in reproductive center of Changzhou maternal and child health care hospital from 2017-2019 were included. The nomogram was built from all participants.Results Three variates significantly associated with the PE occurrence on the HCG administration of infertility women were the type ovulation regiment, basal P and BMI. This predictive model showed good calibration and discriminatory abilities, with an area under the curve (AUC) of 0.639（95%CI 0.596~0.681）. Hosmer and Leme show test were performed for evaluating both calibration and discrimination and confirmed our nomogram is a user-friendly graphical representation of the model (χ2= 4.750，P=0.784)Conclusion The nomogram presents graphically association factors (type ovulation regiment, basal P and BMI) and prediction models which can offer simple and useful guidance to avoid the PE occurrence on the HCG administration for clinicians and infertility patients.